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Cytokine storm after heart transplantation in COVID-19-related haemophagocytic lymphohistiocytosis (HLH).
Mahdavi, Mohammad; Hejri, Golnar Mortaz; Pouraliakbar, Hamidreza; Shahzadi, Hossein; Hesami, Mahshid; Houshmand, Golnaz.
  • Mahdavi M; Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Hejri GM; Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Pouraliakbar H; Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Shahzadi H; Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Hesami M; Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Houshmand G; Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
ESC Heart Fail ; 9(1): 219-223, 2022 02.
Article in English | MEDLINE | ID: covidwho-1530139
ABSTRACT
While severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection primarily causes inflammation in the respiratory system, there is growing evidence of extrapulmonary tissue damage mediated by the host innate immune system in children and adults. A cytokine storm can manifest as a viral-induced haemophagocytic lymphohistiocytosis (HLH). Here, we present a previously healthy 8-year-old boy with newly diagnosed cardiac injury and COVID-19-related HLH syndrome with haemophagocytosis in bone marrow biopsy. After remission of inflammation, the patient underwent a heart transplant due to persistent cardiac failure. The histology of the explanted heart showed only a focal subtle subendocardial inflammation. Three days after transplant, he developed progressive acute respiratory distress syndrome (ARDS) with the rise of inflammatory markers. He unfortunately died after 20 days because of disseminated intravascular coagulation (DIC). For the first time, we described a child with COVID-19-related HLH and severe cardiac failure, which had a poor prognosis despite a heart transplant.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Heart Transplantation / Lymphohistiocytosis, Hemophagocytic / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Adult / Child / Humans / Male Language: English Journal: ESC Heart Fail Year: 2022 Document Type: Article Affiliation country: Ehf2.13728

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Heart Transplantation / Lymphohistiocytosis, Hemophagocytic / COVID-19 Type of study: Case report / Diagnostic study / Prognostic study Topics: Long Covid Limits: Adult / Child / Humans / Male Language: English Journal: ESC Heart Fail Year: 2022 Document Type: Article Affiliation country: Ehf2.13728